Metastatic Prostate Cancer: How It Spreads, Common Sites and Treatment
M1a • distant nodes M1b • bone M1c • other sites Systemic disease Metastatic prostate cancer means prostate cancer cells have spread from the prostate to a distant site in the body. In TNM staging this is M1 disease. The most common clinically important patterns involve distant lymph nodes and bone, while some patients develop […]
Bone Metastases From Prostate Cancer: Symptoms, Diagnosis and Bone Complications
M1b • bone spread Pain • fracture Spine • cord risk Systemic + local care Bone metastases from prostate cancer are deposits of prostate-cancer cells that have spread to the skeleton, making the disease metastatic M1b prostate cancer. They commonly involve the spine, pelvis, ribs and other parts of the axial skeleton. Prostate-cancer bone metastases […]
Metastatic Hormone-Sensitive Prostate Cancer (mHSPC): Definition and Treatment
M1 disease Androgen sensitive ADT foundation Combination treatment Metastatic hormone-sensitive prostate cancer (mHSPC) is prostate cancer that has spread to distant sites but has not become resistant to androgen deprivation. It is also called metastatic castration-sensitive prostate cancer (mCSPC). The cancer may involve distant lymph nodes, bone or other organs, but it remains responsive to […]
Metastatic Castration-Resistant Prostate Cancer (mCRPC): Definition, Progression and Treatment
M1distant metastatic disease TESTOSTERONEmaintained at castrate level PROGRESSIONPSA, imaging and/or clinical STATEmCRPC Metastatic castration-resistant prostate cancer (mCRPC) is prostate cancer that has spread to distant sites and is progressing even though testosterone remains suppressed to a castrate level. It is therefore defined by two separate facts: the cancer is metastatic, and it has become castration-resistant. […]
Prostate Cancer Prognosis: Stage, Grade, PSA, Risk Groups and Survival
Stage • where Grade • biology PSA • activity Health • competing risk Response • over time Prostate cancer prognosis describes the expected course and outcome of the cancer, but it is not determined by one PSA value, Gleason score, stage number or survival percentage. The strongest clinical picture comes from combining anatomical stage, Grade […]
Prostate Cancer Treatment: Active Surveillance, Surgery, Radiation and Systemic Therapy
Risk • biology Stage • extent Intent • control/cure Health • tolerance Preference • trade-offs Prostate cancer treatment is selected from the cancer’s risk group and stage, the purpose of treatment, a person’s health and life expectancy, previous therapy, and the side effects that matter most to that person. Management can range from active surveillance […]
Active Surveillance for Prostate Cancer: Eligibility, Monitoring and Triggers for Treatment
Eligibility • risk PSA • trend MRI • imaging Biopsy • grade Trigger • reclassify Active surveillance is a structured prostate-cancer management strategy that delays immediate surgery or radiation while closely monitoring for evidence that the cancer has become more clinically significant. It is used primarily for suitable low-risk localized prostate cancer and for carefully […]
Active Surveillance vs Watchful Waiting: Goals, Monitoring and Treatment Intent
Goal • intent Patient • fitness Monitoring • intensity Trigger • action Endpoint • cure/control Active surveillance and watchful waiting both avoid immediate prostate-cancer treatment, but they are not the same strategy. Active surveillance is structured monitoring for patients in whom curative treatment remains an option if the cancer becomes more clinically significant. Watchful waiting […]
Radical Prostatectomy for Prostate Cancer: Procedure, Candidates and Outcomes
Cancer • risk Anatomy • removal Nerves • function Pathology • staging PSA • follow-up Radical prostatectomy is a curative-intent operation that removes the entire prostate, its capsule and usually the seminal vesicles, after which the bladder is reconnected to the urethra. Pelvic lymph nodes may also be removed when nodal staging is indicated. The […]
External Beam Radiation Therapy for Prostate Cancer: Planning, Delivery and Side Effects
CT • simulationTarget • contourIMRT • VMATIGRT • motionFraction • schedule External-beam radiation therapy (EBRT) treats prostate cancer by directing high-energy radiation from a machine outside the body toward a precisely planned target inside the pelvis. Modern prostate EBRT usually combines intensity-modulated radiation therapy (IMRT) or volumetric-modulated arc therapy (VMAT) with image-guided radiation therapy (IGRT). […]